Announcements

Change in how MNsure applies the 15/16 rule to eligibility changes

9/15/2017 9:36:39 AM

MNsure will stop applying the 15/16 rule when processing some changes to a consumer’s enrollment. This new policy will be implementing starting September 16. For changes listed below, the changes will be made effective on the first of the following month after the consumer reports the change, regardless of when in the month the change is reported and processed. This change in process will NOT affect termination or SEP effective dates.

Beginning September 16, the following changes will take effect the first of the following month:

Address change with change in eligibility (as long as the change isn’t a decrease in APTC or CSR)

Address change without change in eligibility

APTC increase

With consumer consent

Without consumer consent

APTC decrease

With consumer consent or at the request of enrollee

Demographic data corrections (SSN, name, DOB, gender, etc.)

The following changes will continue to follow the 15/16 rule:

Changes that result in APTC decrease without consumer consent

No SEP effective date rules are impacted by this proposal

For a full explanation of the reason behind this change, and some examples of how this change will be applied, please see /assets/20170915-15-16-rule%20change_tcm34-311386.pdfSummary of QHP/QDP Enrollment Change Effective Date Rules “15/16th” Rule